斯伐他汀对稳定期中重度慢性阻塞性肺病患者炎症因子及肺功能的影响

摘要

Objective To investigate the effect of simvastatin on oxidative stress and inflammatory reac-tion in patients with stable moderate to severe chronic obstructive pulmonary disease and its mechanism. Meth-ods Sixty patients diagnosed with chronic obstructive pulmonary disease were randomly divided into the simvas-tatin group and the placebo group.The simvastatin group was treated with simvastatin in 40 mg/d for 12 weeks,and the placebo group with placebo.The general clinical features,the concentration of inflammatory factors,pulmonary function,6-minute walk test and MRC score were compared between the two groups.Results There was no signif-icant difference between these two groups in basic features. There was a decrease of IL-6,TNF-a and Hs-CRP in concentration in the simvastatin group after treatment. which was significantly lower than that of the placebo group after treatment.The 6-minute walk test in the simvastatin group was much better than that in the placebo group(P=0.00).MRC score was improved compared with therapy before(P=0.02).There was no significantly difference in 6-minute walk test and MRC score before and after treatment in the placebo group(P=0.81). The PaO2 was im-proved after treatment in the simvastatin group compared with therapy before and that in the placebo group after therapy(P<0.05)respectively.There was no significantly difference in FEV1and FVC between these two groups. Conclusion Simvastatin can decrease the concentration of inflammatory factors in stable moderate to severe chron-ic obstructive pulmonary disease,and improve the pulmonary function.%目的 探讨斯伐他汀对稳定期中重度慢性阻塞性肺病患者炎症反应和肺功能的影响并及其机制.方法60例稳定期中重度慢性阻塞性肺病患者被随机分为实验(斯伐他汀)组和安慰剂组,每组各30例,分别接受斯伐他汀(40 mg/d)或安慰剂治疗,持续12周.比较两组患者一般临床基线资料,治疗前后血浆中炎症因子的浓度、肺功能、6分钟步行试验和MRC呼吸困难评分.结果 两组患者一般基础资料无显著差异,实验组血浆中IL-6、TNF-a及Hs-CRP浓度在治疗后显著低于自身治疗前水平及治疗后安慰剂组的水平(P<0.05).实验组6分钟步行试验距离较治疗前显著增加(P=0.00),安慰剂组无统计学差异(P=0.90);实验组MRC评分较治疗前显著降低(P=0.02),安慰剂组则无统计学差异(P=0.81),斯伐他汀组经治疗后PaO2高于治疗前(P=0.00);高于安慰剂组治疗后(P<0.05);两组在FEV1和FVC上差异无统计学意义.结论 斯伐他汀能降低稳定期慢性阻塞性肺病患者血浆中的相关炎症因子浓度,并改善患者肺功能.